肠源性内毒素血症对慢性乙型肝炎患者调节性T淋巴细胞/辅助性T淋巴细胞17的影响  

Influence of intestinal endotoxemia on Treg/Th17 imbalance in patients with chronic hepatitis B

作　　者：李红[1] 曹姗姗[1] 赵亚楠[1] 杨中鑫[1] 

机构地区：[1]山西医科大学第一医院感染病科,太原030001

出　　处：《临床肝胆病杂志》2016年第10期1878-1882,共5页Journal of Clinical Hepatology

基　　金：山西省基础研究计划(自然科学基金)项目(2013011054-3)

摘　　要：目的探讨肠源性内毒素血症(IETM)对慢性乙型肝炎(CHB)患者调节性T淋巴细胞(Treg)/辅助性T淋巴细胞(Th)17的影响。方法选取2014年12月-2015年10月在山西医科大学第一医院住院治疗的CHB患者(CHB组)80例,同时选取健康体检者(HC组)20例作为对照。根据内毒素(ET)水平将CHB组分为ET阳性组和ET阴性组。测定外周血单个核细胞中叉头样转录因子(Foxp3)、维甲酸相关孤核受体γt(RORγt)mRNA的表达,Treg和Th17百分比,以及ALT、HBV DNA水平。计量资料两组间比较采用独立样本t检验,多组间比较用单因素方差分析,进一步两两比较采用SNK-q检验,计数资料组间比较采用χ2检验。结果 CHB组Treg、Th17百分比、Foxp3、RORγt相对表达量与HC组比较均明显增高[(6.51±1.18)%vs(5.91±1.29)%,(4.99±1.07)%vs(4.18±0.87)%,2.12±0.83 vs 1.60±0.70,1.56±0.77 vs 1.09±0.59],P值均<0.05。ET阳性组Treg、Th17百分比、Foxp3、RORγt相对表达量、Th17/Treg、RORγt/Foxp3、ALT水平与ET阴性组比较均明显增高[(6.75±1.17)%vs(6.21±1.14)%,(5.39±1.03)%vs(4.48±0.91)%,2.29±0.90 vs 1.91±0.70,1.84±0.76 vs 1.23±0.64,0.82±0.19 vs 0.74±0.16,0.95±0.38 vs 0.74±0.54,(220.16±115.82)U/L vs(170.86±99.69)U/L],P值均<0.05。ET阳性组HBV DNA载量比ET阴性组增高,但差异无统计学意义(P>0.05)。相关分析表明,CHB患者ET水平与Th17、Treg及ALT呈正相关(r值分别为,P值均<0.05),而与HBV DNA无相关性。结论 CHB患者体内存在的IETM可能通过调控Foxp3、RORγt mRNA表达增加,导致外周血Treg、Th17百分比升高,进而Treg/Th17比例失衡,使HBV难以清除而导致慢性化。Objective To investigate the influence of intestinal endotoxemia on Treg / Th17 imbalance in patients with chronic hepatitis B（ CHB）. Methods A total of 80 patients with CHB who were hospitalized and treated in The First Affiliated Hospital of Shanxi Medical University from December 2014 to October 2015 were enrolled as CHB group,and 20 healthy controls who underwent physical examination were enrolled HC group. According to the serum level of endotoxin（ ET）,the CHB group was further divided into ET-positive group and ET-negative group. The mRNA expression of Foxp3 and RORγt,percentages of Treg and Th17,serum level of alanine aminotransferase（ ALT）,and HBV DNA level in peripheral blood mononucleated cells were measured. The independent samples t-test was used for comparison of continuous data between any two groups,a one-way analysis of variance was used for comparison between multiple groups,and the SNK-q test was used for further comparison between any two groups; the chi-square test was used for comparison of categorical data between groups. Results Compared with the HC group,the CHB group showed significant increases in the percentages of Treg（ 6. 51% ±1. 18% vs 5. 91% ± 1. 29%,P〈0. 05） and Th17（ 4. 99% ± 1. 07% vs 4. 18% ± 0. 87%,P〈0. 05） and relative expression of Foxp3（ 2. 12 ± 0. 83 vs 1. 60 ± 0. 70,P〈0. 05） and RORγt（ 1. 56 ± 0. 77 vs 1. 09 ± 0. 59,P〈0. 05）. Compared with the ET-negative group,the ET-positive group showed significant increases in the percentages of Treg（ 6. 75% ± 1. 17% vs 6. 21% ± 1. 14%,P〈0. 05） and Th17（ 5. 39% ± 1. 03% vs 4. 48% ± 0. 91%,P〈0. 05）,relative expression of Foxp3（ 2. 29 ± 0. 90 vs 1. 91 ± 0. 70,P〈0. 05） and RORγt（ 1. 84 ± 0. 76 vs 1. 23 ± 0. 64,P〈0. 05）,Th17 /Treg ratio（ 0. 82 ± 0. 19 vs 0. 74 ± 0. 16,P〈0. 05）,RORγt/Foxp3 ratio（ 0. 95 ± 0. 38 vs 0. 74 ± 0. 54,P〈0. 05）,and serum level of ALT（ 220. 16 ± 115. 82 U / L vs 170. 86 ± 99. 69 U / L,P〈0. 05）. The ET-positive grou

关 键 词：肝炎 乙型 慢性 内毒素血症 T淋巴细胞 辅助诱导 CD4阳性T淋巴细胞 

分 类 号：R512.62[医药卫生—内科学]